Hakuna Matata

The saga of the cheating students resolved, with me feeling very sheepish. I went in on Monday, new test in hand, and repeated my integrity and learning talk. They looked at me blankly, as usual, and proceeded to ace that new test as well. I did not take my eyes off them and there’s no way they could have cheated this time. The majority of them got 90% or better. After deliberating this fact for a while, I did the only thing I could think of doing—I humbly apologized for misjudging them.

That, plus the fact that Ryan left and our trio is now down to 2, put me in a funk for the rest of the day. The rest of my week has been low key, with only one more CPR class for students. I may teach some staff next week if the hospital can figure out a good time. In the meantime I’m working on a couple of continuing medical education presentations. I was feeling bad that I’m not actually seeing patients, though I’ve got mixed feelings about that. As health care volunteers, we should never be replacing work that can be done by locals, who understand the cultural needs of their community better than we ever could. They will be here with their health systems and government policies long after we’re gone. Any work done by a foreign volunteer has to be sustainable. So, while I’d like to see some patients in the community, it may not happen.

I did have the opportunity to attend a training for Community Health Volunteers, who are a very interesting group. In a global health course I took once, I read a statistic that something like half the world receives their health care from non-medically licensed volunteers. At first I was horrified by that knowledge, picturing these individuals walking around with a bag of antibiotics that they’d hand out randomly—guessing whether someone had TB, AIDS or malaria. But I’ve since done more research on these programs and some are quite resourceful. A good program recruits volunteers much the way Red Cross does, providing them with training, supervision and incentives for their work. They go into their own community where they are well known and respected and operate under very specific protocols. There is a public health post, whose nurses oversee their caseload. Based on some basic algorithms they refer any possibly anemic pregnant women, children with malnutrition or possible pneumonia, etc. to the clinic. They log the data and present it at monthly meetings. For 10-15 hours of work per week they get a stipend of about US$20/month. Now that’s dedication. There’s a camaraderie that happens when they get together and lunch and snacks are provided, so the CHVs seem to enjoy their role. It actually makes a lot of sense, to do things this way in low resource countries.

So now that I’m almost halfway done with my commitment, I’ve settled into a slower pace. Back to doing puzzles, and maybe thinking about a couple more touristy beach and safari weekends I could squeeze in. And reconcile myself to cooking strange food in my tired little kitchen, and watch the goats skip by.